Statistical Modeling to Predict Elective Surgery Time: Comparison with a Computer Scheduling System and Surgeon-provided Estimates

Background Accurate estimation of operating times is a prerequisite for the efficient scheduling of the operating suite. The authors, in this study, sought to compare surgeons' time estimates for elective cases with those of commercial scheduling software, and to ascertain whether improvements could be made by regression modeling. Methods The study was conducted at the University of Washington Medical Center in three phases. Phase 1 retrospectively reviewed surgeons' time estimates and the scheduling system's estimates throughout 1 yr. In phase 2, data were collected prospectively from participating surgeons by means of a data entry form completed at the time of scheduling elective cases. Data included the procedure code, estimated operating time, estimated case difficulty, and potential factors that might affect the duration. In phase 3, identical data were collected from five selected surgeons by personal interview. Results In Phase 1, 26 of 43 surgeons provided significantly better estimates than did the scheduling system (P < 0.01), and no surgeon was significantly worse, although the absolute errors were large (34% of 157 min average case length). In phase 2, modeling improved the accuracy of the surgeons' estimates by 11.5%, compared with the scheduling system. In phase 3, applying the model from phase 2 improved the accuracy of the surgeons' estimates by 18.2%. Conclusions Surgeons provide more accurate time estimates than does the scheduling software as it is used in our institution. Regression modeling effects modest improvements in accuracy. Further improvements would be likely if the hospital information system could provide timely historical data and feedback to the surgeons.

[1]  M. Stone Cross‐Validatory Choice and Assessment of Statistical Predictions , 1976 .

[2]  David M. Allen,et al.  The Relationship Between Variable Selection and Data Agumentation and a Method for Prediction , 1974 .

[3]  J. B. Martin,et al.  Surgical demand scheduling: a review. , 1978, Health services research.

[4]  R. Koenker,et al.  Asymptotic Theory of Least Absolute Error Regression , 1978 .

[5]  D G McQuarrie Limits to efficient operating room scheduling. Lessons from computer-use models. , 1981, Archives of surgery.

[6]  G. Rand Sequencing and Scheduling: An Introduction to the Mathematics of the Job-Shop , 1982 .

[7]  R. Mcneilly,et al.  Use of operating theatres. , 1982, British medical journal.

[8]  B. Bloom,et al.  Surgeons and operating rooms: underutilized resources. , 1983, American journal of public health.

[9]  M B Rose,et al.  Scheduling in the operating theatre. , 1984, Annals of the Royal College of Surgeons of England.

[10]  G Bashein,et al.  A Comprehensive Computer System for Anesthetic Record Retrieval , 1985, Anesthesia and analgesia.

[11]  Z. Przasnyski Operating room scheduling. A literature review. , 1986, AORN journal.

[12]  Hancock Wm,et al.  Patient-scheduling methodologies. , 1992 .

[13]  C. J. Stone,et al.  Logspline Density Estimation for Censored Data , 1992 .

[14]  D M Hamilton,et al.  Operating Room Scheduling: Factors to Consider , 1994 .

[15]  W J Mazzei,et al.  Operating room start times and turnover times in a university hospital. , 1994, Journal of clinical anesthesia.

[16]  F Dexter,et al.  Decreases in Anesthesia-Controlled Time Cannot Permit One Additional Surgical Operation to Be Reliably Scheduled During the Workday , 1995, Anesthesia and analgesia.

[17]  Franklin Dexter,et al.  Analysis of Strategies to Decrease Postanesthesia Care Unit Costs , 1995 .